This is a competing renewal application for midcareer investigator award in patient-oriented research (K24). Since the inception of the current funding period (4 years), the applicant has been very productive. He published 46 additional manuscripts (31 original articles, 15 reviews, additional 11 under peer review) and 5 book chapters, trained (or training) 17 mentees (medical students, post-graduate fellows and junior faculty 16 of which is either in academic medicine or directly involved in Patient Oriented Research) and obtained substantial extramural funding (renewal of R01 and participating in U01). In terms of career achievements, he was promoted with tenure status at his institution, assumed the Directorship of the Master of Science in Clinical Investigation (MSCI) Program (the most prominent educational platform for translational research at his institution), has been accepted to the American Society of Clinical Investigation and named as an Associate Editor of Journal of the American Society of Nephrology. In this current competing renewal proposal, the applicant intends to continue his multi-faceted POR and mentoring activities. As the Director of Clinical Research in Nephrology, he plans to maintain the successful mentoring process established during the current funding period. He will continue to support the past, current and future mentees for securing extramural funding (12 grants secured for mentees). As the Director of MSCI program, he aims sustain the current success rate (56 graduates to date with > 90% staying in academic medicine and >50% with extramural funding) and expand to additional avenues consistent with the Institution's mission. The applicant proposes 2 novel research projects, both in line with his overall research goals, i.e. to examine the nutritional and metabolic derangements of catabolic disease conditions utilizing kidney disease as a model. In study 1, he aims to elucidate the mechanisms by which chronic inflammation and insulin resistance influence the development of uremic wasting in chronic hemodialysis (CHD) patients. In study 2, he aims to examine the acute and chronic effects of an amino acid supplementation and an anti-catabolic agent, individually and combined, on protein homeostasis in CHD patients at physiological and cellular levels. If successful, the proposed studies have great potential to influence clinical practices in kidney disease patients because they are easily accessible and can ultimately lead to improvements in the hospitalization and death rates.